12-11-2005, 07:48 PM
Tragedy rocks care system: Toddler's death sparks reassessment
By Casey Santee
Idaho State Journal
Sunday, December 11, 2005
Linda Sharp and Angela Blom say the death of 2-year-old Cameron Hamilton, allegedly at the hands of his unlicensed counselor, is giving their field a black eye.
The women, who own a local children's mental health clinic, say Medicaid-funded mental health services for Idaho children are a godsend, but the system is being rampantly abused.
“I can see why the (state) Legislature is concerned about the money,” said Sharp, a licensed clinical social worker. “But we don't want to be the baby thrown out with the bath water.”
Sharp and Blom co-own the Better Outlook Family Resource Center on North Fourth Avenue in Pocatello. The death of Cameron and subsequent arrest of Michelle Bott-Graham, his unlicensed counselor at the now-closed Achieving a Better Life child care center in Chubbuck, has put Sharp and Blom on the defensive because they're in the same line of work.
Bott-Graham, 39, of Pocatello, is well-known in the mental health field for bringing Intensive Behavioral Intervention to Idaho.
She was using the counseling method for children with autism and other developmental disabilities to treat and assess Cameron on Nov. 29 when something went terribly wrong.
Cameron suffered severe head trauma and eventually died. Bott-Graham, who has a criminal record that should have prevented her from working with children, was charged in the case, and Achieving a Better Life has been shut down.
Sharp and Blom hope the state corrects the problems in regulating Idaho's complicated child mental health system so future tragedies can be avoided.
“We're in this for the long haul,” Blom said.
According to Tom Shanahan, Idaho Department of Health and Welfare spokesman, the state's publicly funded children's mental health system got its start because of a lawsuit filed in the 1980s. The “Jeff D.” suit claimed the state's poor weren't able to obtain mental health treatment because of their financial situation.
Five percent of Idaho children - about 18,000 of them - have been diagnosed with “serious emotional disturbances.” Of those, 40 percent need public assistance to get the treatment they need, Shanahan said.
To address that issue, Health and Welfare partnered with the private sector in the mid-1990s to create a statewide system of clinics, such as Achieving a Better Life and Better Outlook. Shanahan said the number of clinics in Idaho has grown exponentially in recent years. There are now 296 psychosocial rehabs in the state. Shanahan didn't have the number in Southeast Idaho. However, Pocatello code enforcement officer Dianna Brush said there are 35-40 of them in the Gate City alone. Two years ago there were less than 10, she said.
According to Sharp, vague regulations and a lack of oversight have created conditions ripe for widespread fraud and safety issues. She said providers are cutting corners to save money by hiring underqualified counselors and not providing nutritious meals, among other means.
Sharp said some Medicaid funded mental health clinics also bill for services not rendered. A parent might pay $3 per hour per child for day care; the clinics bill Medicaid as much as $60 per hour per child for mental health work.
Those rates create an environment where low-income parents might place their children in a Medicaid-funded mental health program because this would essentially mean free day care. Sharp said a clinic can profit from the arrangement by passing off its day care as a Medicaid mental health program.
“We're talking about people making money,” Sharp said.
She said a mother recently approached her upset that her child wasn't able to do fun activities at Better Outlook like some other local clinics offer. Sharp said she explained to this woman that the “fun activities” are not supposed to be part of Medicaid-funded mental health treatment.
Sharp said she told the woman that if day care is what she was after, she should remove her child from Better Outlook.
But in addition to Medicaid problems, Sharp said she has safety concerns about the state's clinics. She said parents have told her horror stories about other clinics in the state, such as children being placed in closet-like time-out rooms.
“Here we've got (taxpayers) putting out all this money but no one coming around to check up on the facilities,” Sharp said. “The state hasn't been watching for all these years. There's not only child abuse happening, but Medicaid abuse as well.”
She said A Better Outlook opened for business in April 2004. She said it was more than a year later, in August of this year, that Health and Welfare officials finally showed up to review the center's records and conduct an inspection.
“They said we would get a report in 60 days, but it never arrived,” she said. “Last week, we got a notice that if we want a copy to contact them.”
Sharp said that's exactly what she did. She said IDHW officials told her they would e-mail the documents immediately. Sharp and Blom are still waiting.
“All we have to go by are these ambiguous rules,” Sharp said, pointing at a 2-inch thick Medicaid mental health manual. “It's a good program, it just needs to be taken care of. There are probably a lot of parents out there who love it because their kids are making progress. Others probably love it because they think it's free day care.”
Shanahan said Idaho lawmakers set up a credentialing process during the last legislative session to address the Medicaid fraud problem. Funding started in July.
“With the credentialing project, we want to do a better job with services and make sure people are treated by counselors who are qualified,” Shanahan said.
When asked about IDHW fraud investigators, he said, “They are very busy.”
Source: Idaho State Journal
http://www.journalnet.com/articles/2005/...news01.txt
By Casey Santee
Idaho State Journal
Sunday, December 11, 2005
Linda Sharp and Angela Blom say the death of 2-year-old Cameron Hamilton, allegedly at the hands of his unlicensed counselor, is giving their field a black eye.
The women, who own a local children's mental health clinic, say Medicaid-funded mental health services for Idaho children are a godsend, but the system is being rampantly abused.
“I can see why the (state) Legislature is concerned about the money,” said Sharp, a licensed clinical social worker. “But we don't want to be the baby thrown out with the bath water.”
Sharp and Blom co-own the Better Outlook Family Resource Center on North Fourth Avenue in Pocatello. The death of Cameron and subsequent arrest of Michelle Bott-Graham, his unlicensed counselor at the now-closed Achieving a Better Life child care center in Chubbuck, has put Sharp and Blom on the defensive because they're in the same line of work.
Bott-Graham, 39, of Pocatello, is well-known in the mental health field for bringing Intensive Behavioral Intervention to Idaho.
She was using the counseling method for children with autism and other developmental disabilities to treat and assess Cameron on Nov. 29 when something went terribly wrong.
Cameron suffered severe head trauma and eventually died. Bott-Graham, who has a criminal record that should have prevented her from working with children, was charged in the case, and Achieving a Better Life has been shut down.
Sharp and Blom hope the state corrects the problems in regulating Idaho's complicated child mental health system so future tragedies can be avoided.
“We're in this for the long haul,” Blom said.
According to Tom Shanahan, Idaho Department of Health and Welfare spokesman, the state's publicly funded children's mental health system got its start because of a lawsuit filed in the 1980s. The “Jeff D.” suit claimed the state's poor weren't able to obtain mental health treatment because of their financial situation.
Five percent of Idaho children - about 18,000 of them - have been diagnosed with “serious emotional disturbances.” Of those, 40 percent need public assistance to get the treatment they need, Shanahan said.
To address that issue, Health and Welfare partnered with the private sector in the mid-1990s to create a statewide system of clinics, such as Achieving a Better Life and Better Outlook. Shanahan said the number of clinics in Idaho has grown exponentially in recent years. There are now 296 psychosocial rehabs in the state. Shanahan didn't have the number in Southeast Idaho. However, Pocatello code enforcement officer Dianna Brush said there are 35-40 of them in the Gate City alone. Two years ago there were less than 10, she said.
According to Sharp, vague regulations and a lack of oversight have created conditions ripe for widespread fraud and safety issues. She said providers are cutting corners to save money by hiring underqualified counselors and not providing nutritious meals, among other means.
Sharp said some Medicaid funded mental health clinics also bill for services not rendered. A parent might pay $3 per hour per child for day care; the clinics bill Medicaid as much as $60 per hour per child for mental health work.
Those rates create an environment where low-income parents might place their children in a Medicaid-funded mental health program because this would essentially mean free day care. Sharp said a clinic can profit from the arrangement by passing off its day care as a Medicaid mental health program.
“We're talking about people making money,” Sharp said.
She said a mother recently approached her upset that her child wasn't able to do fun activities at Better Outlook like some other local clinics offer. Sharp said she explained to this woman that the “fun activities” are not supposed to be part of Medicaid-funded mental health treatment.
Sharp said she told the woman that if day care is what she was after, she should remove her child from Better Outlook.
But in addition to Medicaid problems, Sharp said she has safety concerns about the state's clinics. She said parents have told her horror stories about other clinics in the state, such as children being placed in closet-like time-out rooms.
“Here we've got (taxpayers) putting out all this money but no one coming around to check up on the facilities,” Sharp said. “The state hasn't been watching for all these years. There's not only child abuse happening, but Medicaid abuse as well.”
She said A Better Outlook opened for business in April 2004. She said it was more than a year later, in August of this year, that Health and Welfare officials finally showed up to review the center's records and conduct an inspection.
“They said we would get a report in 60 days, but it never arrived,” she said. “Last week, we got a notice that if we want a copy to contact them.”
Sharp said that's exactly what she did. She said IDHW officials told her they would e-mail the documents immediately. Sharp and Blom are still waiting.
“All we have to go by are these ambiguous rules,” Sharp said, pointing at a 2-inch thick Medicaid mental health manual. “It's a good program, it just needs to be taken care of. There are probably a lot of parents out there who love it because their kids are making progress. Others probably love it because they think it's free day care.”
Shanahan said Idaho lawmakers set up a credentialing process during the last legislative session to address the Medicaid fraud problem. Funding started in July.
“With the credentialing project, we want to do a better job with services and make sure people are treated by counselors who are qualified,” Shanahan said.
When asked about IDHW fraud investigators, he said, “They are very busy.”
Source: Idaho State Journal
http://www.journalnet.com/articles/2005/...news01.txt